I’m often asked for advice from mothers of children who have a persistently sore, dry and cracked ‘clown’s mouth’ – chapped lips and a ring of scaly red soreness around the mouth.
Very cold or very hot weather or particularly dry winds can make lips dry and flaky or chapped. Licking to ease the dryness leads to a vicious circle of lip licking, dryness, redness, and chapping since the moisture from the saliva dries out the lips even further – which one thinks is a moistening act.
So you can get further dryness, chapping, and scaling which can extend beyond the lip area to all around the mouth. The redness and skin irritation can keep on spreading, leading to fungal or bacterial infection.
The result is ‘Lip-licking’ eczema’ (or Lip-licker’s Dermatitis), a form of chronic atopic eczema that affects the lips and surrounding area as the result of habitual licking of the lips. The skin around the mouth looks red and dry with cracks and fissures and it can become thickened – lichenified – in the area between the nose and upper lip and over the lips themselves.
Lip-licking commonly occurs in those with a depressive or anxiety problem. It is particularly frequent among children and it can be difficult to break what becomes a lip licking habit.
Sometimes lip-licking is combined with habitual rubbing above the upper lip with the side of an index finger. Lip-licking eczema also be caused by excessive thumbsucking and may also be linked to irritation from, or allergy to, toothpaste. Chronic rhinitis, associated with hayfever, may also be part of the problem, causing a runny nose.
The good news is that, given the opportunity, skin around the mouth and lips heals quite quickly. The bad news is that lip-licking and rubbing is a habit and there are no short cuts. You must embark on a programme of habit-reversal, combined with effective topical treatment.
Habitual behaviour is largely unconscious so the first step is to develop an awareness of the licking or rubbing. If you can leave the skin free from habitual licking and/or rubbing long enough – at least 4 weeks – then your skin will heal itself quickly. Combining this with an optimal use of creams will clear the problem.
If you can get to London, the specialist to consult is PsychoDermatologist Dr Christopher Bridgett at Chelsea & Westminster Hospital.
The excellent habit-reversal techniques (for all types of eczema scratching, not just lip-licking) devised by Dr Bridgett and Consultant Dermatologist Richard Staughton are second to none and work for everyone. Next best thing is to read how to follow them in Sue Armstrong-Brown’s book, The Eczema Solution.901020M CF
Here are a couple of habit-reversal ideas:
For rubbing with a finger: Clench the fist and hold for 30 seconds to counteract the urge to rub.
For lip-licking: To begin with, to increase awareness of the habit, apply a thin strip of hydrocolloidal gel dressing (from any chemist) to the thickened skin between the upper lip and the nose. Then replace the lip-licking with a positive behaviour by holding the lips still and firmly closed together for 30 seconds to combat the urge to lick. This is the equivalent of making a fist, and you may create other safe behaviours to help.
In conjunction with the habit-reversal techniques apply a topical steroid like Eumovate twice a day. Barrier Balm_1024x1024Cover this with a light, gentle smear of Theraplex Barrier Balm which has the Seal of Acceptance of the National Eczema Association, or the wonderfully soothing Sea-Med Organic Seaweed Rescue Balm. Apply without rubbing or massaging, several times an hour.
The Sea-Med Balm is natural and non-toxic (important as it gets swallowed) and, like the petroleum jelly of Theraplex, can be used on broken skin.Balm
You can use cosmetic lip creams and balms to moisturise and protect the lips but make sure you use an unfragranced type or one that does not contain chemical irritants.